Incidence and survival outcomes in patients with upper urinary tract urothelial carcinoma diagnosed with variant histology and treated with nephroureterectomy
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- Stefania Zamboni
- Klinik für Urologie Luzerner Kantonsspital Lucerne Switzerland
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- Beat Foerster
- Department of Urology Vienna General Hospital Medical University of Vienna Vienna Austria
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- Mohammad Abufaraj
- Department of Urology Vienna General Hospital Medical University of Vienna Vienna Austria
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- Thomas Seisen
- Department of Urology Pitié Salpêtrière Hospital Sorbonne University Paris France
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- Morgan Roupret
- Sorbonne Université GRC n°5 ONCOTYPE‐URO AP‐HP Hôpital Pitié‐Salpetrière Paris France
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- Pierre Colin
- Department of Urology Générale de Santé Hôpital Privé de La Louvière Lille France
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- Alexandre De la Taille
- 79 Department of Urology INSERM U955Eq07 Centre Hospitalier Universitaire Mondor Assistance Publique des Hôpitaux de Paris Paris France
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- Carlo Di Bona
- Klinik für Urologie Luzerner Kantonsspital Lucerne Switzerland
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- Benoit Peyronnet
- Department of Urology Hopital Pontchaillou CHU Rennes Rennes France
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- Karim Bensalah
- Urology Rennes University Hospital (France) Rennes France
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- Roman Herout
- Department of Urology University Hospital Carl Gustav Carus Dresden Germany
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- Manfred Peter Wirth
- Department of Urology University Hospital Carl Gustav Carus Dresden Germany
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- Vladimir Novotny
- Department of Urology University Hospital Carl Gustav Carus Dresden Germany
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- Francesco Soria
- Karl Landsteiner Institute of Urology and Andrology Vienna Austria
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- Piotr Chlosta
- Department of Urology Jagiellonian University Krakow Poland
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- Alessandro Antonelli
- Urology Unit ASST Spedali Civili Brescia Italy
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- Claudio Simeone
- Urology Unit ASST Spedali Civili Brescia Italy
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- Philipp Baumeister
- Klinik für Urologie Luzerner Kantonsspital Lucerne Switzerland
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- Agostino Mattei
- Klinik für Urologie Luzerner Kantonsspital Lucerne Switzerland
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- Francesco Montorsi
- Unit of Urology/Division of Oncology IRCCS Ospedale San Raffaele URI Milan Milan Italy
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- Giuseppe Simone
- Department of Urology “Regina Elena” National Cancer Institute Rome Italy
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- Michele Gallucci
- Department of Urology “Regina Elena” National Cancer Institute Rome Italy
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- Kazumasa Matsumoto
- Department of Urology Kitasato University School of Medicine Kanagawa Japan
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- Pierre I. Karakiewicz
- Department of Urology University of Montreal Montreal QC Canada
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- Alberto Briganti
- Unit of Urology/Division of Oncology IRCCS Ospedale San Raffaele URI Milan Milan Italy
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- Evanguelos Xylinas
- Department of Urology Bichat Hospital Paris Descartes University Paris France
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- Shahrokh F. Shariat
- Department of Urology Vienna General Hospital Medical University of Vienna Vienna Austria
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- Marco Moschini
- Klinik für Urologie Luzerner Kantonsspital Lucerne Switzerland
説明
<jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the incidence and survival outcomes of histological variants of upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>We retrospectively analysed data from 1610 patients treated with RNU for clinically non‐metastatic UTUC between 1990 and 2016 in several centres participating in the UTUC Collaboration. Histological variants were classified as micropapillary, squamous, sarcomatoid and other, including other rare variants (<10 cases for each). Multivariable competing risk analyses were conducted to assess the effect of variant histology on overall recurrence and cancer‐specific mortality (CSM).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Overall, 1460 patients (91%) had pure urothelial carcinoma (PUC), whereas 150 (9%) were diagnosed with a variant histology, including 89 (5.0%), 41 (2.0%), 10 (1.0%) and 10 (1.0%) cases of micropapillary, squamous, sarcomatoid and other tumours, respectively. Variant histology was associated with the presence of adverse pathological features compared with PUC, including non‐organ‐confined disease (59% vs 38%; <jats:italic>P</jats:italic> < 0.001), lymph node invasion (28% vs 24%; <jats:italic>P</jats:italic> = 0.02), high‐grade disease (88% vs 71%; <jats:italic>P</jats:italic> < 0.001), tumour necrosis (28% vs 16%; <jats:italic>P</jats:italic> = 0.001) and positive surgical margins (15% vs 8%; <jats:italic>P</jats:italic> = 0.01). In competing risk analysis, micropapillary variant was the only factor associated with worse recurrence (sub‐hazard ratio [SHR] 2.27, 95% confidence interval [CI] 1.25–4.79; <jats:italic>P</jats:italic> = 0.02) whereas sarcomatoid variant was associated with worse CSM (SHR 16.8, 95% CI 6.86–41.17; <jats:italic>P</jats:italic> < 0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>We found that one out of 10 patients with UTUC treated with RNU had variant histology. Only micropapillary and sarcomatoid variants were associated with poorer oncological outcomes after adjusting for available confounding factors.</jats:p></jats:sec>
収録刊行物
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- BJU International
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BJU International 124 (5), 738-745, 2019-04-07
Wiley
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詳細情報 詳細情報について
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- CRID
- 1360568470438633472
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- ISSN
- 1464410X
- 14644096
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- データソース種別
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- Crossref
- KAKEN